To the Editor, Show We read with great interest the recent report by Pinto et al. The authors correctly point out that dental handpieces should be steam sterilized between patient use and provide evidence that external disinfection of dental handpieces with alcohol is unsafe. However, there is a possibility that readers may wrongly assume that there is an ongoing search for a way to safely disinfect these instruments, when surface disinfection or immersion in disinfectant are not acceptable reprocessing methods for dental handpieces. The U.S. Centers for Disease Control and Prevention 2003 guidelines state the following: “Manufacturer's instructions for cleaning, lubrication, and sterilization should be followed closely to ensure both the effectiveness of the process and the longevity of handpieces.” 2
Guidelines for infection control in dental health-care settings—2003.
In 2016, further clarification was made,Dental handpieces and associated attachments, including low-speed motors and reusable prophylaxis angles, should always be heat sterilized between patients and not high level or surface disinfected. Although these devices are considered semi-critical, studies have shown that their internal surfaces can become contaminated with patient materials during use. If these devices are not properly cleaned and heat sterilized, the next patient may be exposed to potentially infectious materials. 3
Summary of infection prevention practices in dental settings: basic expectations for safe care.
The authors paid meticulous attention to the surface disinfection protocols. However, they neglected to test the internal components when assessing the level of contamination of the disinfected handpiece. Surgical power tools can be considered the weak link in the decontamination cycle and present a potential for iatrogenic transmission of infection, mainly because their internal complex designs may restrict access to cleaning and sterilization agents. Indeed, after surface disinfection of these dental instruments, the internal turbine mechanism retains blood and saliva, as well as viruses and bacteria. , , , Viable microorganisms could therefore be expelled during subsequent patient treatment, making strict adherence to dental handpiece sterilization a professional imperative. Instrument sterilization is a cost-effective, evidence-based practice for patient safety. It is true, however, that contrary to the highest safety standards, compliance with handpiece sterilization remain a major challenge for dental education and professional practice worldwide. In a recent survey (2013-2014) among 207 dentists recently graduated from 43 schools of dentistry in Latin America, only 35% declared that they were trained to sterilize handpieces between patients. 9
Dentists survey on adverse events during their clinical training.
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Article InfoPublication HistoryPublished online: June 15, 2017 FootnotesConflicts of interest: none to declare. IdentificationDOI: https://doi.org/10.1016/j.ajic.2017.04.294 Copyright© 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. ScienceDirectAccess this article on ScienceDirect
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Related ArticlesHow do you sterilize dental handpieces?These devices should be cleaned using mild liquid disinfectants, premoistened wipes, or commercially available dental handpiece cleaners. A soft-bristle toothbrush or instrument brush can be used to clean external surfaces of handpieces and related attachments.
What is the best method to sterilize a handpiece?The recommended method for sterilisation of hollow handpieces, such as turbines and contra-angles, is by using the correct, validated autoclave cycle that delivers saturated steam, under pressure at the highest temperature compatible with the load, typically 134-137°C for at least a 3-minute holding time.
What is the best method of sterilization in the dental office?Most dental offices use steam to sterilize dental tools and instruments by heating them past the boiling point in an autoclave. Steam is ideal for destroying microorganisms such as bacteria and spores, and can sterilize solids, liquids, hollow items, and instruments of various shapes and sizes.
What is the best way to maintain a sterile handpiece?Tips for handpiece care & maintenance. External Cleaning. Clean the outer casing of handpiece with a soft to medium bristle brush and alcohol or warm water. ... . Thermal Washer Disinfector. ... . Lubricate & Clean Internally. ... . Expel Debris and Excess Lubricant. ... . Sterilize. ... . Let Cool & Dry. ... . Check Air Supply.. |